West Brunswick Tennis Club

ABN 61 053 986 944

Membership 1 July 17 – 30 June 18

Junior Being less then 18 years of age as at 1 July 2017

Concession Being a full-time student, or being a person in receipt of a current Seniors, Pensioner or Low Income Heath Care Card.. A copy of concession card must be emailed to

Family Parents/Guardians or partnered adults including dependent Junior members

Note: Competition play memberships includes fees for participation in NSNTA (Tue, Wed and Thu night) and NSLTA (Thu day) competitions. Additional payment is due for junior grades using new balls, NSTA and pennant competition.

New Member Once only joining fee $40 per individual or $80 per family $ A

Junior $110

Adult - court access and competition play $255

- court access only $165

Concession - court access and competition play $230

- court access only $140

Family - 1 adult and juniors, court access and competition $510

- 2 adults and juniors, court access and competition $420

- adults and juniors court access only $330 $ B

Note: Pro-rata fees are available for New memberships. These are applied automatically if joining online, or please contact the club via for the amount due.

Total payable: (A+B) $

Primary Applicant Details

Surname / First Name / Gender (M/F)
Mobile ( / Home ( / Date of Birth
Email
Residential Address
Postal Address
(if different)


Details of others included in this membership

Surname / First Name / D.O.B / Gender / Email and mobile phone (if over 15)

Payments:

Direct Debit: Bendigo Bank BSB 633-000 Account 1464 83979

Please include your name as a reference

Cheque or Money Order: Make payable to “West Brunswick Tennis Club Inc”

Please include the name of the member on the back of the cheque

Tennis Victoria Declaration

Your membership will be registered in the Tennis Australia My Tennis database. The terms and conditions can be found at

http://www.tennis.com.au/wp-content/uploads/2012/03/Terms-and-Conditions-of-My-Tennis-Registration.pdf

and on a noticeboard in the clubrooms.

I acknowledge the My Tennis Terms and Conditions:

Privacy Policy: Tennis Victoria requires the information requested on this form to provide you with membership benefits, to receive timely and relevant information and communications related to tennis and for related purposes which can be reasonably expected. In addition, we may use your personal information to advise you of promotions, events, special offers and other like activities offered by Tennis Victoria or its stakeholders. You are able to access your personal information through Tennis Victoria upon reasonable notice. Except where permitted or required by law, or where your consent is obtained, this information will not be disclosed to third parties.

I acknowledge the Tennis Victoria Privacy Policy:

As part of being a tennis member, it is expected that you will receive tennis specific communications from time to time from your club, state body and/or national body.

You do however have the option to opt out of marketing related communications.

I do not wish to receive marketing related communications.

Completed membership forms can be returned via email to

or post to PO Box 72, West Brunswick 3055